BMC microbiology · 2026
Phage cocktails for the disinfection of carbapenem-resistant Klebsiella pneumoniae on high-touch surfaces in intensive care units.
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He Yao, Liu Tingting, Wang Shuzhen, Ji Ziying, Zhang Liming, Han Xiaojian, Wan Yuying
Аннотация
BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of hospital-acquired infections, particularly in intensive care units (ICUs). Chemical disinfectants are widely used for environmental decontamination in ICUs. However, their long-term application is associated with bacterial tolerance, material corrosion, and reduced lifespan of frequently touched surfaces. Environmentally friendly and effective alternative disinfection strategies are therefore urgently needed.
RESULTS: CRKP remained viable on high-touch ICU surfaces for at least 72 h on stainless steel and up to two weeks on cotton fabrics. In liquid culture, high concentrations of phages XDRKpn-1, XDRKpn-2, and the phage cocktail reduced CRKP populations by approximately 4 log units within 12 h. In biofilm inhibition assays, phages XDRKpn-1 and XDRKpn-2 achieved inhibition rates of 78.66% and 64.22% at 109 PFU/mL, respectively (P < 0.05), while the phage cocktail resulted in a 77.64% reduction in biofilm biomass (P < 0.05).When applied to high-touch ICU surface materials, individual phages achieved maximum reduction rates of 99.94% on cotton, 99.75% on stainless steel, 99.74% on plywood, and 99.81% on plastic. The phage cocktail exhibited comparable or enhanced bactericidal activity, achieving reduction rates of 99.994%, 99.998%, 99.74%, and 99.93% on cotton, stainless steel, plywood, and plastic surfaces, respectively.
CONCLUSIONS: Phages XDRKpn-1 and XDRKpn-2 effectively reduced CRKP contamination on ICU-relevant high-touch surfaces under laboratory conditions, highlighting their potential as a targeted and environmentally friendly alternative or complement to conventional chemical disinfectants. However, further studies are required to validate their efficacy and stability in the complex, real-world ICU environment.
RESULTS: CRKP remained viable on high-touch ICU surfaces for at least 72 h on stainless steel and up to two weeks on cotton fabrics. In liquid culture, high concentrations of phages XDRKpn-1, XDRKpn-2, and the phage cocktail reduced CRKP populations by approximately 4 log units within 12 h. In biofilm inhibition assays, phages XDRKpn-1 and XDRKpn-2 achieved inhibition rates of 78.66% and 64.22% at 109 PFU/mL, respectively (P < 0.05), while the phage cocktail resulted in a 77.64% reduction in biofilm biomass (P < 0.05).When applied to high-touch ICU surface materials, individual phages achieved maximum reduction rates of 99.94% on cotton, 99.75% on stainless steel, 99.74% on plywood, and 99.81% on plastic. The phage cocktail exhibited comparable or enhanced bactericidal activity, achieving reduction rates of 99.994%, 99.998%, 99.74%, and 99.93% on cotton, stainless steel, plywood, and plastic surfaces, respectively.
CONCLUSIONS: Phages XDRKpn-1 and XDRKpn-2 effectively reduced CRKP contamination on ICU-relevant high-touch surfaces under laboratory conditions, highlighting their potential as a targeted and environmentally friendly alternative or complement to conventional chemical disinfectants. However, further studies are required to validate their efficacy and stability in the complex, real-world ICU environment.